MEDICARE: GEORGE L SCHMIDT OD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier	OPC 1306	FL

General Provider Information

NPI Number	:	1992952386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE L SCHMIDT OD PA

Provider Business Mailing Address
First Line	:	9123 N MILITARY TRL
Second Line	:	STE 101
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-5968
Country	:	US
Telephone Number	:	561-622-8200
Fax Number	:	561-622-8308

Provider Business Practice Location Address
First Line	:	9123 N MILITARY TRL
Second Line	:	STE 101
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-5968
Country	:	US
Telephone Number	:	561-622-8200
Fax Number	:	561-622-8308

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GEORGE LEWIS SCHMIDT
Credential	:	OD
Telephone Number	:	561-622-8200

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	11/30/2011

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